Hydrocephalus

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Hydrocephalus Diagnosis & Tests

Tapping with the fingertips (percussion) on the skull may show abnormal sounds associated with thinning and separation of skull bones. Scalp veins may appear dilated.

The circumference of the head may be large, or there may be enlargement of only part of the head, most commonly the frontal area. Measurements of the circumference of the head, repeated over time, may show progressive enlargement.

The eyes may be depressed, with a "setting-sun" sign where the sclera (white portion of the eye) is visible above the iris (colored portion of the eyes). A neurologic examination may show focal neurologic deficits (localized loss of function), and reflexes may be abnormal for the age of the child.

Tests:

• Transillumination of the head (shining a light against the head) may show abnormal fluid accumulation in various areas of the head.
• A head CT scan indicates if hydrocephalus is present (best test).
• A lumbar puncture (spinal tap) and examination of the CSF may be performed (rarely).
• Skull X-rays show thinning and/or separation of skull bones and enlargement of the skull.
• A brain scan using radioisotopes may show abnormalities of the fluid pathway.
• An arteriography of brain blood vessels may show vascular causes of hydrocephalus.
• An echoencephalogram, a form of ultrasound of the brain, may show dilation of the ventricles caused by hydrocephalus or intraventricular bleeding.